Depression Anxiety Stress Scale

Original Editor - Rucha Gadgil

Top Contributors - Rucha Gadgil, Jess Bell, Kim Jackson, Manisha Shrestha and Lucinda hampton  

Introduction[edit | edit source]

The Depression, Anxiety and Stress Scale - 42 Items (DASS-42) is a set of three self-report scales designed to further the process of defining, understanding, and measuring the ubiquitous and clinically significant emotional states of depression, anxiety and stress[1]. DASS-21[1] is the shorter version of the test with the same three domains. It was designed by the Psychology Foundation of Australia.

DASS-42 has 14 items in each domain while the DASS-21 has seven. Each domain assesses the negative emotional symptoms on a four-point likert scale. A greater score indicates higher severity of these negative symptoms[2].

An earlier version of the DASS scales was referred to as the Self-Analysis Questionnaire (SAQ). The DASS is based on a dimensional rather than a categorical conception of psychological disorder. The assumption on which the DASS development was based (and which was confirmed by the research data) is that the differences between the depression, the anxiety, and the stress experienced by normal subjects and the clinically disturbed, are essentially differences of degree.

Components of the Scale[edit | edit source]

There are three components of the scale:

  1. Depression scale: assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest / involvement, anhedonia and inertia.
  2. Anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect.
  3. Stress scale: assesses difficulty relaxing, nervous arousal, and being easily upset / agitated, irritable / over-reactive and impatient.

Instrument details[edit | edit source]

It is a patient-reported questionnaire with scoring from 0-3. The total scoring is 63 for the DASS-21 and 126 for the DASS-42.

The Scales can be found here:

  1. DASS-21: here
  2. DASS-42: here.

Intended Population[edit | edit source]

It can be used by both researchers and scientist-professional clinicians to assess the emotional states in general population, patients with chronic pain, etc.

Materials and Time[edit | edit source]

Time required: 5-10 mins.

Materials: Questionnaire and a pen/pencil.

Training Required: No training

Cost[edit | edit source]

The the questionnaire is free of cost and the manual may be ordered for a nominal fee of $55.00 from the DASS website.

Psychometric Properties[edit | edit source]

  1. Reliability: excellent test-retest reliability (r=0.71-8.81)[3]
  2. Validity: strong convergent validity of the DASS-21 in older adults, acceptable discriminative validity[4]. Excellent criterion validity (r=0.65)
  3. overall good-to-excellent internal consistency (cronbach's alpha: 0.96,0.89,0.93 for each component respectively)[4]

References[edit | edit source]

  1. 1.0 1.1 Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety & Stress Scales. (2nd Ed.)Sydney: Psychology Foundation.
  2. Taylor R, Lovibond PF, Nicholas MK, Cayley C, Wilson PH. The utility of somatic items in the assessment of depression in patients with chronic pain: a comparison of the Zung Self-Rating Depression Scale and the Depression Anxiety Stress Scales in chronic pain and clinical and community samples. Clin J Pain. 2005 Jan-Feb;21(1):91-100. doi: 10.1097/00002508-200501000-00011. PMID: 15599136.
  3. Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol. 2012 Dec;68(12):1322-38. doi: 10.1002/jclp.21908. Epub 2012 Aug 28. PMID: 22930477.
  4. 4.0 4.1 Gloster AT, Rhoades HM, Novy D, Klotsche J, Senior A, Kunik M, Wilson N, Stanley MA. Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients. J Affect Disord. 2008 Oct;110(3):248-59. doi: 10.1016/j.jad.2008.01.023. Epub 2008 Mar 4. PMID: 18304648; PMCID: PMC2709995.